FAQ

We are pleased to help you with questions you may have about our practice, services, and protocols. At Hand to Shoulder Center of Wisconsin, it is our mission to provide you with not only exceptional upper extremity care, but to enrich you with a better understanding on questions you may have. Please click on the link below which will assist you with your questions.

Appointments and Referrals

How do I make an appointment at Hand to Shoulder Center of Wisconsin?

Patients are seen by appointment only. An appointment may be made by calling (920) 730-8833 or toll free at (888) 383-3039, Monday through Friday between the hours of 8:00 A.M. and 5:00 P.M. or use our electronic form on our Schedule a Consultation page.

Do I need a referral (authorization)?

If your insurance policy requires that you have a referral or authorization to visit our specialists, it is your responsibility to obtain that authorization.

All authorizations must be received by Hand to Shoulder Center of Wisconsin before the time of your appointment.

Authorization made by Hand to Shoulder Center of Wisconsin for tests, evaluation, or services to be provided to the patient by other providers are the full financial responsibility of the patient.

What do I need to bring to my first appointment?

If applicable, worker’s compensation or third party insurance information.

If applicable, records and imaging (x-rays and radiology reports).

Bring in any medications you are currently taking in the original bottle which contains the name of the medication and the dosage.

Insurance and Billing

Health Insurance

Check your insurance coverage – DON’T ASSUME ANYTHING.

Due to the constant changes with insurance policies and the many levels of coverage, it is your responsibility to understand your policy and to contact your insurance company to guarantee you are scheduled with an in-network physician, facility, and/or therapist.

Important questions to keep in mind when talking to your insurance company:

Do you need a pre-authorization or referral from your primary care physician to get better payment benefits on your office visit at Hand to Shoulder Center of Wisconsin?

Do you have restrictions on the number of visits you are allowed?

Does your policy cover both occupational and physical therapy?

Co-pays

Many insurance policies have co-pay amounts due at the time of the appointment. It is our policy to collect all co-pay amounts at the time of your appointment.

What if I don’t have health insurance?

Patients who have no insurance will be asked to make a good faith payment at each visit. You will meet with a Financial Services Coordinator who will assist you in setting up a Payment Agreement for the balance of your fees.

What are the fees for your services?

We have a schedule of fees for all services provided from office visits to the most complicated procedures relating to injuries and disorders of the finger, hand, wrist, forearm, elbow and shoulder. If you have questions regarding our fees please call one of our billing specialists and they will assist you.

How will I be billed?

Your visit will include an examination and discussion of a treatment plan recommended for your condition. There is a fee for these services and for follow-up visits.

Charges may be incurred for any dressing, cast, x-ray or equipment used or supplied.

Any supplies not covered by insurance will be the patient’s responsibility. Payment is due at the time of your visit for co-pays and for all non-covered supplies provided.

To insure prompt processing of your claims, we require that you provide us with all primary and if applicable, secondary health insurance carriers you may have.

You will be required to provide your health insurance card(s) at the initial visit.

It is your responsibility to notify us of any changes in your insurance status.

Please note that there is a potential for patients to receive three (3) bills to be sent out monthly.

One bill is for your physician’s care, one for therapy services, if applicable, and one from Woodland Surgery Center, if applicable. Please understand that you, the patient, are responsible for the bills from your doctor, your therapist, and/or from Woodland Surgery Center.

We accept most insurances and will bill your insurance company as a courtesy.

We accept most insurances and will bill your insurance company as a courtesy.

If your insurance requires you to be seen by an in-plan provider, please verify with your insurance carrier that our clinic is in your plan. Your health insurance coverage is a contract between you and the insurance company. Your health insurance may reimburse you for part or all of your bills, but that is between you and the insurer.

Approximately 1-2 weeks after a service is rendered to you, we will send a statement to you and your insurance carrier.

Normally within 30-45 days, we will receive full or partial payment from your insurance carrier.

At that time, you will be billed for the difference between the insurance company’s payment (if not paid in full) and the doctors fee.

Balances are due in full within ten (10) days of receipt unless other payment arrangements are made.

You may discuss a payment schedule with a Financial Services representative at the time of your visit or by calling (920) 730-8833.

What if I have a question about my bill?

One of our billing specialists will be happy to assist you. We are committed to providing excellent service to our patients. We encourage you to call our office at (920) 730-8833 during office hours regarding billing questions.

Will I be billed separately by the anesthesiologist if I have surgery?

Yes, you will receive a separate bill from your anesthesiologist for his/her professional services.

Medical Records

Do you prepare disability forms, special reports, insurance forms and medical-legal letters?

In accordance with the general policy of this area, a fee is charged for the preparation of special letters to insurance companies, lawyers, and other third party clients. Payment of fee is required prior to completion of the form(s).

All forms and reports require you, the patient, to give Hand to Shoulder Center of Wisconsin written permission to release personal medical information. Authorization forms are available at Hand to Shoulder Center of Wisconsin upon request, or can be accessed online: Authorization for Release of Medical Records.

Please include your mailing address on your request. If you have questions, please call our office for more information at: (920) 730-8833 or (888) 383-3039.

Worker’s Compensation and 2nd Opinion

What if my injury is Worker’s Compensation?

If you have not filed a first report of injury with your employer and feel your condition or injury is work-related, please contact your employer to discuss your condition.

A first report of injury must be reported to your employer.

It is the responsibility of the employer to notify their worker’s compensation insurance carrier of the injury. The worker’s compensation insurance carrier will assign you a claim number. Our office will need this information to process your claim.

Schedule an appointment with one of the seven fellowship-trained orthopedic physicians at Hand to Shoulder Center of Wisconsin.

At the time of check-in a receptionist will assign a worker’s compensation coordinator from our clinic to meet with you. You will be given information regarding worker’s compensation, and you will also have the opportunity to ask questions that apply to your claim.

A job description from your employer may be requested if causation of the injury is questionable.

In the event that you have a claim number and have filed your first report of injury with your employer, it does not guarantee that you have an accepted workman’s compensation claim.

Following your first consultation, your worker’s compensation insurance carrier will request medical records and documentation before accepting and paying for the claim.

In the event of a review and/or denial, due to the length of time some reviews can take, it is our policy to obtain your primary and/or secondary health insurance information allowing our billing department to file your claims with your health insurance carrier in a timely fashion. This will expedite processing of your claims in the instance of a worker’s compensation denial.

In the event of a denial, feel free to contact your worker’s compensation coordinator and they will assist you with questions of an appeal on a denied claim.

Worker’s Compensation and 2nd Opinion

Contact our office to schedule an appointment.

Provide the reason you are seeking a second opinion.

Provide previous records and imaging that pertain to this specific injury or condition.

When these records have been received by our office, the physician assigned to your case will review your records.

A receptionist will contact you to schedule your appointment request.

At the time of your appointment, bring your worker’s compensation insurance name, mailing address, and claim number that is assigned to your case, along with your adjustor’s name and phone number.

Provide personal healthcare insurance if applicable. If self-pay, a financial coordinator from Hand to Shoulder Center of Wisconsin will meet with you.

Check-in with a receptionist at front desk.

A worker’s compensation coordinator at Hand to Shoulder Center of Wisconsin will meet and be assigned to your case to assist you with questions you may have.

Meet with the doctor for your initial consultation.

Provide job expectations.

Hand Therapy may be necessary. Please note that this is a separate entity of our practice.

Please give at least a 24 hour notice for any cancellation.

Things to expect

Complete review and diagnosis.

Treatment options.

Options may include splints, medications, injections, therapy, or surgery.

Worker’s Compensation – Return to Work

At each physician’s appointment, a Return to Work/Restriction form will be provided to you at the conclusion of your visit. This form will provide your employer with the necessary information on your return to work status.

Provide your human resource contact person with your current Return to Work form.

Surgery

Is there a difference between upper extremity surgery and other types of surgery?

The healing process makes surgery on the finger, hand, wrist, forearm, elbow and shoulder different from most other types of surgery.

For example, in appendicitis the disease is cured once the diseased organ is removed; in hand and upper extremity surgery the structures within the hand and upper extremity are returned to anatomic position. However, for tendons to glide once again, nerves to transmit impulses, and joints to rotate, these structures must heal first and this, by definition, involves the formation of scar tissue. Since there are more moving parts in close relationship in the hand and upper arm than anywhere else in the body, many of these parts, even those not injured are caught in the necessary web of the healing wound. Adhesions form between these structures. With time, the scar tissue softens and yields to the force pulling the healed tendon through it. Helping improve scar mobility, gliding of the healing structures and optimizing joint range of motion is one of the main goals of therapy.

Will I need occupational or physical therapy after my orthopedic surgery?

The return of good function following hand and upper extremity injuries, crippling arthritis, or during the postoperative recovery is very possible and will occur in due time with careful occupational or physical therapy, the appropriate exercises, and splinting. Occupational and physical therapy will get you through the rough periods of the postoperative process. If you want a good result, it can be yours; but experience has shown that it is very difficult to achieve this alone and that your function will improve significantly faster with therapy.

Where do your surgeons perform surgery?

All seven orthopedic surgeons at Hand to Shoulder Center of Wisconsin perform surgery at Woodland Surgery Center located adjacent to the Appleton clinic. The outpatient surgery center offers a convenient and cost-effect alternative from a hospital admission.

In addition, Drs. Toivonen, Cherney, Lumsden, Olvey, Cullen, Van Zeeland, and Butler have surgical privileges at the three Fox Cities hospitals (ThedaCare Regional Medical Center-Neenah, ThedaCare Regional Medical Center-Appleton, and St. Elizabeth Hospital). Surgical privileges are defined as having the accessibility to perform procedures and surgeries, order labs and treatment, along with the ability to admit patients to the hospital at these locations.

Third Party Liability

What if I have a third party liability injury?

If you believe a third party is responsible for the services rendered to you as the patient, please obtain the third party insurance information prior to your initial visit. It is our policy to submit charges to the third party insurance carrier for primary payment until the benefits are exhausted. Please ask to speak to our Financial Services department if you need further assistance or clarification.